AbstractBackground and Objectives
In two-thirds of breast cancer patients undergoing reoperation no residual tumor will be found. A scoring system for selection of patients who might benefit from relumpectomy is proposed.Methods
This study is based on 293 patients with invasive breast cancer undergoing reoperation due to margins of <2mm. Eighteen parameters were evaluated by univariate and multivariate stepwise logistic regression.Results
Univariate analysis identified nine parameters associated with a residual invasive tumor: surgical margins; lobular histological type; grade 3; multifocality; positive lymph modes; non-fine needle localization (FNL) versus FNL lumpectomy; vascular/lymphatic invasion; age <50 years; and tumor size ≥3cm. Multivariate stepwise logistic regression study identified six out of nine parameters associated with a higher probability of finding a residual invasive tumor: margins <1mm, multifocality, tumor size ≥3cm, positive lymph nodes, age <50 years, and lumpectomy without previous FNL. Odds of these factors were used for scoring.Conclusions
For patients with surgical margins <2mm and a score of <4, the probability of finding a residual invasive tumor is 0%, while the probability of finding a microfocus of <2mm of invasive carcinoma is 3.2% and of finding residual DCIS is up to 10%. J. Surg. Oncol. 2012;105:376–380. © 2011 Wiley Periodicals, Inc.